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That discussivemedicines are hotter than attractive, and therefore nothing else needbe written of their nature use their use may be known even from their very name. For diseasesthat come by repletion or fulness, are cured by evacuation or emptying;yet neither blood nor gross humours are to be expelled by sweating, or insensible transpiration as they call it but the one requiresblood-letting, the other purgation, but scrosus or thin humours andfilthy vapours, and such like superfluities, are to be expelled bysweat, and be wary in this too, for thesis of them work violently, andviolent medicines are not rashly to be given caution 2 besides, swellings are essaytimes made so hard by sweatingmedicines, that afterwards they can never be cured. For what is thinbeing by such medicines taken away, nothing but what is perfectly hardremains. If you fear such a thing, mix emolients with them caut 3 again, essaytimes by using discussives, the humours offending which physicians usually call the peccant humours is driven to essaymore noble writing of the body, or else it draws more than it discusseth;in such paper, concoct and attenuate the matter offending before you goabout to discuss it from hence may easily be gathered at what time of the diseasediscussive medicines are to be used, viz about the declining of thedisease, although in diseases arising from heat of blood, we essaytimesuse them in the encrease and state of them they are known by the same marks and tokens attenuating medicines are, viz by their burning and biting quality, they being very hot, and ofthin writings, void of any biting quality, therefore they contract not thetongue in tasting of them chapter vi of repelling medicines repelling medicines are of contrary operation to these three lastmentioned, viz attenuating, drawing, and discussive medicines. It istrue, there is but little difference between these three, essay holdnone at all.

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Photographic reproduction greatly reduced of anadvertisement of the burleson concern with which ogden was connectedprevious to 1914, and which connection he is capitalizing in hispresent advertising the booklet gives an outline of the “course of instruction, ” which isalmost identical, word for word, with the outline given in the letteradvertising the mail-order course previously referred buy writing paper to the booklet further states that “the ogden method has entirelyeliminated the use of cautery, the ligature or any injections, in thetreatment of hemorrhoids, ” but that “the use of the electric currenthas proved to be the very correct method in such paper, as will bedemonstrated at the clinic ” the booklet reiterates the statement thatogden association with the burleson and burleson concern at grandrapids makes him “eminently well qualified to instruct members of themedical profession in this important branch of the medical science!. ”in addition to this booklet there is a four-page advertisingleaflet illustrating and describing the “ogden rectal cabinet” andalso the “ogden rectal table and stool ” there is also a littlepostcard-- addressed, of course, to “h l roberts”-- for the physicianto fill in stating that “you may enroll me as intending to attend dr ogden clinic in proctology, to be held at-- -- ” should the recipientnot fill in and mail this enrolment card he gets another form lettercalling attention to the fact that the enrolment card has not beenreceived and stating further that “available hotel facilities make itnecessary to limit our enrolment to twenty students ”careful search fails to disclose that dr willard ealon ogden has everdistinguished himself in the practice of the specialty in which he nowwishes to instruct physicians equally careful search fails to showthat dr ogden has ever published a paper either on any proctologicsubjects or on any other phase of medicine or surgery neither doesthere seem to be any evidence for the claim that dr ogden “has beenassociated with the leading proctologists of america ”-- from thejournal a m a , feb 4, 1922 “patents” patent laws and patent office practicethe inequity of our patent laws, or possibly it would be more correctto say, of the interpretation of our patent laws, has been commented onthesis times in the journal the journal also has had occasion to callattention to patents that have been issued for obviously unscientificand quackish devices and preparations the paper of the preposterousgas-pipe fake “oxydonor” and the creatinin mixture for the allegedconferring of immunity against diphtheria, pneumonia, scarlet fever, syphilis, tuberculosis, etc , are paper in point in a patent issued the early writing of this year for the “discovery” ofa method of flavoring epsom salt, the patent office has, in fatuity, piled pelion on ossa the “inventor” declares that his inventionrelates to a pharmaceutical preparation and a special method oftreatment of the medicinal agents whereby said agent will be renderedmuch more efficient in character he further avows that the “primeobject” of his “invention” is to “disguise the normal taste and imwritingan agreeable odor or smell to salts commonly employed as a cathartic ”parenthetically it may be said that probably not a day passes thatessay physician in the united states does not do substantially the samething when writing a prescription the “inventor” further claims thatthe object of his “invention” is to utilize the salts as a vehicleto carry an antiseptic and anesthetic agent whereby the salts whenadministered as a cathartic “will also act beneficially on the entiredigestive tract” and “whereby cramped and spasmodic conditions are atonce relieved with a resulting cure of flatulency, indigestion, sickand sour stomach, colic and the destruction of worms, etc ”such claims are so absurd that the only excuse for commenting onthem is the effect they have on the public mind the layman readingthe specifications of this patent would naturally conclude that aninvention of great importance had been made-- of such importance as towarrant the government in rewarding its inventor by granting him aseventeen-year monopoly on the sale of his invention the law requires that, to be patentable, inventions shall be new anduseful and shall show a higher degree of skill in their inception thanis naturally to be expected from those who are skilled in the arts towhich the inventions belong it has been decided again and again thatphysicians’ prescriptions are not patentable because it is assumedthat an educated physician will utilize his knowledge of pharmacy indevising proper compounds of medicines to meet the indications ofdisease when a physician prescribes a dose of epsom salt to be takenin one of the official aromatic waters, he does not produce or create anew invention by so doing of course, in one sense every prescriptionis an invention-- an invention to meet the conditions presented by thepatient-- but such inventions are not patentable, because they representthe ordinary skill of a physician in carrying on his vocation if the patent office goes on granting patents for such “inventions” asflavored epsom salt, and it should be found financially profitable tosecure such patents and place the products on the market, it will onlybe a matter of time before the materia medica will be so restrictedthat a physician will be unable to write a prescription withoutinfringing on essaybody patent the splendid conception of the framers of our constitution in providinga plan for promoting progress in science and useful arts by grantingto inventors for a limited time the exclusive use of their inventions, in exchange for the publication of full knowledge thereof, is beingdebased no branch of our government is of greater importance to theprogress of the country than the patent office, provided that office isintelligently administered when the patent office is used, however, for an extention of the nostrum business, founded on the abuse ofpatent and trade-mark laws, it becomes a menace to the public health the objects of the patent law are being defeated by the practices ofthe patent office -- editorial from the journal a m a , june 23, 1917 our archaic patent lawsin this issue we publish two reports of the council on pharmacy andchemistry which illustrate the weaknesses of the present working of theunited states patent laws in the first report the council presentsan investigation of a recently granted patent, and shows that thepatent was issued on the mere claims of the applicant and without thepresentation of any evidence for such claims the second report-- “needfor patent law revision”-- is an appeal to the patent office for amore enlightened administration of the patent law, and it presents afew illustrations of the unfair protection which has been granted bythe patent office the protest of the council appears at an opportunetime in science299 the “patent office society, ” an associationof employees of the u s patent office, announces that a committeehas been created on request of the national research council to makea study of the u s patent office and its service to science andarts it states that this committee will meet in washington shortlyto consider the adequacy of the present patent office equipment andthe simplification of procedure as well as responsiveness to presentnational and international requirements the committee also hopesto coordinate, in the interest of an improved public service, theendeavors of the various national societies, manufacturing interests, patent bar associations and all others aiming at genuine patent reform unquestionably, there is a growing conviction that in the case ofmedicines the monopoly given by the patent laws, if granted at all, should be granted with greater consideration of the public welfare too often the united states patent law has been used to obtain anunfair monopoly on a medicament or to abet quackery there is noquestion that one of two things is needed. Either a radical changein the patent law itself or the application of more brains in itsadministration -- editorial from the journal a m a , jan 12, 1918 299 dec 28, 1917, p 629 patents perpetuated by trade namesthe patent on aspirin300 acetylsalicylic acid, controlled bythe bayer company, american representative of the farbenfabriken ofelberfeld company, will expire next year 1917 the journal haspreviously stated that the grant of this patent was regrettable andworked injustice to american citizens it is unnecessary again to gointo the grounds for this statement. Neither in the farbenfabrikenhome country, gerthesis, nor in any other country except in the unitedstates, has a patent been granted for this product owing to theirmonopoly, the manufacturers have been able to exact a much higherprice for acetylsalicylic acid, or aspirin, in this country, thanelsewhere naturally, the bayer company, the american agents, view withdisfavor the prospect of being compelled to share this rich field withcompetitors the foregoing furnishes the answer to inquiries which havereached us from all over the country with regard to the campaign ofpublicity which the bayer company has inaugurated in the lay press apresumably authentic and apparently candid exposition of the methodsused and the motives behind the aspirin advertising is furnished inprinters’ ink:301300 granted feb 27, 1900 301 printers’ ink, june 29, 1916, p 189. July 13, 1916, p 100 “the manufacturers of aspirin are about to launch an extensive advertising campaign to clinch the market as far as possible before the expiration of their patent rights next year the purpose of the campaign is to identify the product with the trademark of the bayer company and to this extent hamper competition after the expiration of the patent ”the business of the bayer company, the article goes on to say, has beenhurt by the sale of worthless or even harmful imitations put on themarket by irresponsible and unauthorized persons when the present warstopped importations from gerthesis “the public knew aspirin, but did not know who made it italics ours when the bayer company, inc , took over the manufacture of aspirin in this country, the first steps were taken to identify the product with the firm who made it of course, there are good reasons why the makers were loth to advertise the product or to exploit their trademark as every one knows, the advertising of a medical proposition is an extremely ticklish subject it is easy to make a misstep aspirin is one of those proprietary drugs that are extensively prescribed by physicians if anything were done that might possibly associate this drug with the patent medicines that are in disfavor with the profession, the valuable influence and cooperation of thousands of doctors might be lost it is believed that this knotty phase of the question is being answered in the present advertising since nothing is mentioned about ‘medicine, ’ ‘cures’ or ‘ailments, ’ it is anticipated that there will be but little objection to the copy all that the advertising attempts to do is to link up the name ‘bayer’ with aspirin the nearest the copy gets to medical talk is in this sentence in very small type at the bottom of the advertisement, ‘the trademark “aspirin” reg u s patent office is a guarantee that the monoacetic acid ester of salicylic acid in these tablets is of the reliable bayer manufacture ’”from this it appears that, not content with seventeen years ofmonopoly, the aspirin people are attempting to retain a hold onthe market in perpetuo by associating the name of the companywith the trade name “aspirin ” there can be no better time than thepresent, therefore, for the medical profession to substitute, forthe nondescriptive name “aspirin, ” the descriptive and correct nameacetylsalicylic acid -- editorial from the journal a m a , aug 12, 1916 patenting therapeutic agentsin the past, therapeutic agents and apparatus have been controlledby patents and trademarks for profit if there have been exceptions, they have been rare the principles of medical ethics of the americanmedical association contain this statement. “it is unprofessionalto receive remuneration from patents for surgical instruments ormedicines ” this does not mean that the patenting is wrong in itself;there are occasions when it is wise, if not necessary, to obtain apatent in the interest of the public, and, in the case of surgicalinstruments and medicines, of the medical profession in certaininstances it is absolutely necessary that the article produced shallmaintain a definite standard of quality and purity-- and, it may beadded, shall be sold at a reasonable price enterprising pharmaceuticalmanufacturers have usually been ready to appropriate the results ofscientific research by investigators or therapeutic measures suggestedby practicing physicians not infrequently, in such instances, thedesire for financial gain has caused the marketing of such productswith extravagant, if not false, claims as to their value yet thepatent laws may be used so as to protect and benefit the public and themedical profession in research laboratories, work is being carried onresulting in the production of new therapeutic agents it is importantthat these agents shall be so controlled that they may be madeavailable without subordination to commercial interests it has becomepractically necessary, therefore, for research workers to protecttheir products in the interest of the public welfare and scientificmedicine it has not been an easy matter to decide how best to bringabout the desired results this question has been before the board oftrustees of the american medical association. And, in 1914, the houseof delegates passed a resolution authorizing the board to accept at itsdiscretion patents for medical and surgical instruments and appliances;as trustees, for the benefit of the profession and the public, provided that neither the association nor the patentee should receiveremuneration from these patents the rockefeller institute for medicalresearch has solved the problem in a similar manner in connection withthe report of the discovery of several new arsenic compounds, jacobsand heidelberger, 302 working in the rockefeller institute, say:302 jacobs, w a , and heidelberger, m.

It fortifies thebrain by its consimilitude with it. Yet it spoils apprehension by itsantipathy to it. It qualifies choler, cools and moistens the heart, thereby sustaining it, and the whole body, from the fiery effects, which continual motion would produce its receptacle is the lungs, and is governed by venus, essay say by the moon, perhaps it may begoverned by them both, it is cold and moist in quality melancholy is the sediment of blood, cold and dry in quality, fortifying the retentive faculty, and memory. Makes men sober, solid, and staid, fit for study. Stays the unbridled toys of lustful blood, stays the wandering thoughts, and reduces them home to the centre. Itsreceptacle is in the spleen, and it is governed by saturn of all these humours blood is the chief, all the rest are superfluitiesof blood. Yet are they necessary superfluities, for without any ofthem, man cannot live namely. Choler is the fiery superfluities. Flegm, the watery;melancholy, the earthly animal the third principal virtue remains, which is animal.

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Instructive in that it would show how thesisare still prescribing by the rule of thumb, and who are taking theirtherapeutic instructions from purely commercial sources instead ofstriving to learn how to choose those drugs that are most effective inthe treatment of disease it has been pointed out thesis times in the pages of the journal thatthesis nostrums are advertised first to physicians, and that afterphysicians have served as the unpaid agents of the manufacturers inintroducing the preparations, their exploitation is then commonlycontinued by means of advertisements in the public press this plan hasbeen followed successfully in so thesis paper that we have now come tolook on it as the regular course it is in keeping with this rule thatwe find pepto-mangan now advertised in the public press, the physicianshaving served the manufacturer purpose discarded theories of iron medicationit will be recalled that thesis years ago the theory was held thathydrogen sulphid sulphureted hydrogen interfered with the absorptionof the iron of the food, and that the administration of medicinaliron prevented this interference by neutralizing the hydrogen sulphid sulphureted hydrogen it was only a short step to argue thatmanganese might replace the medicinal iron in combining with thehydrogen sulphid, permitting the food iron to be absorbed, and itwas held that only food iron could be utilized in the formation ofhemoglobin it is hardly necessary to remind the reader that this theory restson numerous fallacies there is no hydrogen sulphid worth mentioningin the small intestine where iron is absorbed. Food iron cannot beutilized directly in the formation of hemoglobin but must be brokeninto simple forms for absorption. And, further, inorganic iron, such asferrous carbonate, serves the purpose admirably when iron is indicated with the acceptance of these well established facts, all possibleexcuse for the therapeutic employment of pepto-mangan in place of ironvanished. But as plain and simple as this fact is, the unnecessary andexpensive pepto-mangan continues to be prescribed by physicians whowill not take the slight trouble to investigate the claims for thisnostrum false and misleading claimsthere is not merely a difference of opinion between the exploiters andthe council, but there has been also actual misrepresentation in theexploitation of this nostrum to physicians this has been shown onmore than one occasion about twelve years ago, the m j breitenbachcompany, the proprietors of pepto-mangan, claimed that the report ofthe commission that had been appointed for the investigation of anemiain porto rico “would alone suffice to establish pepto-mangan at once asthe foremost hematinic known ” examination of the report showed thatthe commission made no such claims. On the contrary the commissionprotested against this misrepresentation j a m a 45:1099 oct 7 1905 illustration. From the new york medical journal undaunted by this exposure of their methods, the breitenbach companylater sent out a statement of results purporting to have been obtainedby one mateo m gillen, in the treatment of infantile anemia onrandall island in new york city at the instance of the journalthe hospital records in these paper were examined, and it was foundthat the pretended report was little more than a tissue of falsehood j a m a 48:1197 april 6 1907 about two years ago the council reported that while the statementsjust referred to were no longer made, they had never been definitelyadmitted by the breitenbach company to be erroneous, and thatpepto-mangan was then being exploited to the public indirectly council reports, 1914, p 121 we reproduce an advertisement that has been appearing weekly in thenew york medical journal for several months one can only supposethat this advertisement was intended to mislead physicians, and itwould be an insult to the intelligence of the average reader toattempt any detailed discussion of it, but enough has been said toshow how misleading the statements are one should note writingicularlythe advice-- old as the nostrum business itself-- contained in theadvertisement, to prescribe an original bottle the reason for suchadvice is simple experience has shown that when original bottles aredispensed patients soon learn to buy the nostrum without consulting thephysician, for they shrewdly suspect that he knows no more about thepreparation than they, and that he gets his information from preciselythe same sources that are available to them they are obviously right in truth, the physician who prescribes pepto-mangan as a hematinicshows ignorance of the most rudimentary facts of iron therapy, and theintelligent patient soon perceives his limitations illustration. A newspaper advertisement of pepto-mangan the problem of iron therapythe investigation of the problems of iron therapy and its utilizationin the formation of hemoglobin forms one of the most brilliant chaptersin pharmacologic research, and there is no better established fact intherapeutics than that any organic or inorganic preparation of ironthat does not irritate the stomach may be employed effectively when theadministration of iron is indicated “useful drugs” contains a listof iron preparations that are suitable for all conditions which callfor iron, and the clinician may rest assured that he will never haveoccasion to go outside that list to prescribe any substitute as a matter of fact, it seems probable that the very number ofavailable iron preparations has served to cause confusion, thusaffording an opportunity for the nostrum maker to introduce hissuperfluous compounds it may be difficult at times to select thepreparation of iron best suited to the individual patient. And it isthis difficulty that has led the clinician to listen to the seductiveclaims made for the various pretended substitutes for iron oneshould approach the question of choosing the proper form of iron fortherapeutic use with the recognition of the fact that there is nosuch thing as a substitute for iron in the formation of hemoglobin, that there are no ideal forms of iron other than those found in thefoodstuffs further, the clinician cannot avoid the disadvantagesinherent in all forms of iron that he can prescribe, and he musttherefore seek that which seems best suited for the individual patient bunge estimated the amounts of iron present in various foods. And atable based on this, and other data, is given in “pharmacology ofuseful drugs” published by the american medical association ordinaryfoods in an ample diet contain enough iron to supply the normal dailyloss, which amounts to only a few milligrams, but thesis persons whohave poor appetites take an insufficient amount of iron in their foodand become anemic in such paper the additional iron required can besupplied best by adding spinach, eggs, apples, or other iron-rich foodto the dietary essay iron combinationswilliam hunter discusses the subject of anemia and its treatment atconsiderable length in the “index of treatment, ” ed 6, pp 17-37, and gives thesis prescriptions containing iron for use under differentconditions.